Regulatory and Reimbursement Committee Blog

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Regulatory and Reimbursement Committee

Regulatory and Reimbursement Committee
Goals, Objectives, and Responsibilities
  1. To represent the Hospital/Healthcare Financial community and to present issues with proposals of Legislation and other governmental changes that could impact revenue to the facility/healthcare systems.
    • Consult with Legislators, Insurance Payers, and others in order to resolve the issues for services and supplies rendered by the facility/healthcare systems.
    • Oversee any inconsistencies and recommend corrective action via comments to the appropriate state or national official.
    • Identify the problematic HEALTHCARE MARKET issues and concerns.
    • Obtain input from the Committee via their recommendations.
    • Ensure that an appropriate financial resolution is finalized, if at all possible.
  2. To diversify the Regulatory and Reimbursement Committee by assignment.
    • Institute the FALL QUARTERLY MEETING with appropriate speakers and topics that will communicate the future of healthcare as it effects the Hospital community
    • Assist the Board with pro-action in submission of comments through the Board President to appropriate government legislators on proposals of new bills that may affect healthcare reimbursement.
    • Inviting this committee and/or the entire Chapter to participate in quarterly "informational sharing" events on current issues with resolutions, prior to the start of the committee meeting, via conference call-in.
    • Encourage the publication of our legislative comments and other newsworthy information through local Chapter's publication, Focus and also the National magazine.
    • Continue to give assistance when needed to ensure favorable contract terms, deterring any possibility of lost revenue to the Healthcare facilities involved.
    • To encourage attendance via the Healthcare Community when applicable.
    • View Publications/Attend Statewide meetings when possible to have continual awareness on the issues of Healthcare.
  3. Assist with NJHA and other Healthcare agencies in addressing and resolving the issues or concerns to the Healthcare Financial community.
  4. Increase the Managed Care membership/participation in the committee by surveying needs of Managed Care Directors and Consultants, and designing special in-services to address their industry needs.
  5. Coordinate efforts with the Board to solicit NJHA membership and participation in the Pro Action/Reimbursement/Managed Care Committee for those who are newly hired or promoted within the Hospital Reimbursement field.
  6. Incorporate a succession plan into the committee planning.
Committee Chair
Peter Demos
Company: MERIDIAN HEALTH
 Phone: (732) 751-3378

E-mail: peter.demos@hackensackmeridian.org
Committee Co-Chair
Rachel Simms
Company: RUTGERS UNIVERSITY BEHAVIORAL
 Phone: (732) 235-3420

E-mail: rsimms@ubhc.rutgers.edu